- gestational anomaly of the placenta consisting of a bunch of clear vesicles. This neoplasm is formed form the selling of the chronic villi and lost nucleus of the fertilized egg. The nucleus of the sperm duplicates, producing a diploid number 46 XX, it grows & enlarges the uterus vary rapidly.

Medication: Methotrexate to prevent choriocarcinoma

Assessment:

Early signs - vesicles passed thru the vagina

Hyperemesis gravidarium increase HCG

Fundal height

Vaginal bleeding( scant or profuse)

Early in pregnancy

-High levels of HCG

-Preeclampsia at about 12 weeks

Late signs -hypertension before 20th week

-Vesicles look like a “ snowstorm” on sonogram

-Anemia

-Abdominal cramping

Serious complications

Ø hyperthyroidism

Ø Pulmonary embolus

Nursing care:

Ø Prepare D&C

Ø Do not give oxytoxic drugs

Ø Teachings:

ü Return for pelvic exams as scheduled for one year to monitoring HCG and assess for enlarged uterus and rising titer could indicative of choriocarcinoma

3. Placenta succenturiata – 1 or 2 more lobes connected to the placenta by a blood vessel may lead to retained placental fragments if vessel is cut. 4. Placenta Circumvalata – fetal side of placenta covered by chorion 5. Placenta Marginata – fold side of chorion reaches just to the edge of placenta 6. Battledore Placenta – cord inserted marginally rather then centrally 7. Placenta Bipartita – placenta divides into 2 lobes 8. Vilamentous Insertion of cord- cord divides into small vessels before it enters the placenta 9. Vasa Previa – velamentous insertion of cord has implanted in cervical OS